Optometrist Assistant Stuff Part 2
When using VISION insurance such as Superior, VSP, Davis, Avesis, etc, how do you know what to put in the allow section?
If they get contacts, look in CL section and write that number, if not, write the VA number.
Do patients ever owe what is in the allow box?
NO
Does the amount of money in the allow box have anything to do with what the patient owes?
NO
Does the allow number have anything to do with what patients pay out of pocket?? Explain
NO!! They only pay their copay plus whatever extra stuff they want.
If a patient comes in and uses UHC medical or BCBS medical, what do you put in the AR?
Name and ID number only (Delilah will do the rest)
If a patient wants a Visual Field Exam (VF) or a Dilation exam (DFE), where in Excel would you put the charge for their visit?
VF Etc.
When calculating BCBS or UHC medical insurance, if a patient has a $10 copay and their allowable is $260, how much do you need to add to the allow section to correctly reflect the amount owed and why?
$10 so it will say $270, that way the computer will calculate the amount owed to be $260
If a patient is not insured, where in Excel would you put the charge for their visit?
Exam section
So you're looking at the United Healthcare system under copays and coinsurance to find the patients copay and you see no notes in the vision optometry section. What do you do next?
Look to see if there are notes in the medical care section and use THAT copay.
If you do the 367.1 code and you see that it says not covered, what should you try next?
Medical code 784
What does the allow number always need to reflect?
The amount owed (by the insurance)
You are reading a prescription and you notice that there are no numbers in the cylinder section, what does that mean?
The patient does not have an astigmatism
You are reading a prescription and you see that no cylinder power has been prescribed, what does this mean?
The patient does not have an astigmatism
When using the United Healthcare system and looking under copays and coinsurance, what does it mean if there are no notes in the vision section?
The patient doesn't have an eye exam avaliable
You are reading a prescription and the doctor has written numbers in the cylinder section of the prescription page, what does this mean?
The patient has an astigmatism
If you're looking at the United Healthcare system under copays and coinsurance and you don't see any notes, what does that mean for the patient?
They don't have a (free) eye exam available.
What do you do for the doctor if someone is coming in for a medical follow up?
Write medical follow up @ (whatever time) and stick it on their chart, then put it on the doctor's desk.
When calculating BCBS or UHC medical insurance, how do you know which number to put in the allow section so it reflects the amount owed? Explain.
You add the allowable to the copay and put that total number in the allow section.
When calculating BCBS or UHC medical insurance, if a patient has a $15 copay and their allowable was $275, how would you figure out what to put in the allow section? After the calculation, what number would you put in the allow section?
You would need to add $15 to $275 which equals $290 and that's what you would put in the section?
When calculating BCBS or UHC medical insurance, if a patient has a $35 copay and their allowable is $260, how would you figure out what to put in the allow section? What number would you come up with after the correct calculation?
You would need to add $35 to $260 which equals $295 and that's what you would put in the section.
When calculating BCBS or UHC medical insurance, what is the formula for calculating the allow so it reflects the amount owed?
allowable plus copay
If the United Healthcare Estimator doesn't work, where should you look to find patient copay and exam info?
copays and coinsurance
If you try the 367.1 code and it says no coverage, you need to make sure you do the _____________.
medical code
How do you close the credit card machine?
push first purple button, then f2, then settlement (then it prints)
If a patient is using vision insurance such as Superior, VSP, Davis, Avesis, etc, and they get contacts, where would you look to find the number to put in the allow section?
the CL section
If a patient is using vision insurance such as Superior, VSP, Davis, Avesis, etc, and they do not get contacts, where would you look to find the number to put in the allow section?
the VA section
